Information technology has long been recognized at the University of Michigan Medical Center (UMMC) as an important issue. However, until recently, there has not been an organization to lead the integration effort. In August, 1988, the UMMC was awarded an IAIMS Planning Grant and since that time have completed the specific aims outlined in the proposal and expanded far beyond what we ever imagined. Now that the planning phase has been completed, a new organization, office, etc., is leading the institution into the model development phase. The foundation of the University of Michigan IAIMS program is built upon four major elements that are interrelated; and the pilot projects proposed in this application will strengthen our understanding of and commitment to them: (1) effective access to external information within the Medical Center, (2) methods to capture and structure available information for use; (3) integration of existing information resources; and (4) building of an "IAIMS without walls". While it is difficult to completely capture the richness and complexity of our environment in a concise way, these four elements are essential components of the IAIMS at the University of Michigan. They provide at least the flavor of our ultimate goals. During this model development phase, our overall specific aims are as follows: (1) understand and develop appropriate inforrnation technologies and strategies for this environment based on the experience derived from selected pilot projects; (2) encourage and make feasible a greater level of communication and information sharing among users of information technology internally as well as externally; (3) assess mechanisms to capture and structure information for wide-spread access; and (4) develop a methodology to assist in the inte- gration of information resources. We have achieved many successes since being awarded the Phase I grant and believe that we will continue and exceed this level of success during Phase 11.